System Title

Page 1 of 5
INTEGRATED HEALTH, SAFETY AND ENVIRONMENT STANDARD PROCEDURES Document No. ADM-FRM-005-1

Procedure Title
Effective Date 01 Jan 2018

HSE RISK MANAGEMENT

Revision / Date 3 / 10 Sep 2017

HSE RISK ASSESSMENT FORM

Risk Assessment Type New Review Date of Issue

Company Freiburg Contracting & General Maintenance LLC Division/Department HSE

Describe Activity and Location Work at height

Prepared by Name Designation Date and Signature

Approved by Name Designation Date and Signature

Ports HSE Department Approval

Name Designation Date and Signature

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Page 2 of 5
INTEGRATED HEALTH, SAFETY AND ENVIRONMENT STANDARD PROCEDURES Document No. ADM-FRM-005-1

Procedure Title
Effective Date 01 Jan 2018

HSE RISK MANAGEMENT

Revision / Date 3 / 10 Sep 2017

Legal
Risk Assessment Residual Risk Assessment
S Existing Legal Compliance Additional Controls
Hazard Title Hazard Detail Causes Consequences Existing Controls
No. Requirements Proposed
Y N P A E R RI P A E R RI

Activity:

DOCUMENT ELECTRONICALLY CONTROLLED - PRINTED COPIES VALID FOR FOURTEEN (14) WORKING DAYS
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 System Title
Page 3 of 5
INTEGRATED HEALTH, SAFETY AND ENVIRONMENT STANDARD PROCEDURES Document No. ADM-FRM-005-1

Procedure Title
Effective Date 01 Jan 2018

HSE RISK MANAGEMENT

Revision / Date 3 / 10 Sep 2017

Legal
Risk Assessment Residual Risk Assessment
S Existing Legal Compliance Additional Controls
Hazard Title Hazard Detail Causes Consequences Existing Controls
No. Requirements Proposed
Y N P A E R RI P A E R RI

• Ensure all the • Ensured that every

workers should be worker should have
inducted proper PPE
• Permit to work • Every worker should
should be obey site safety rules
followed • All the workers should
• Well trained be third party trained
workers both for work at height
external and • Internal training should
internal be done on daily bases
• Conducting TBT prior to start the
on daily bases activity
• Training should be • Safe access and egress
arranged on daily should be provided and
bases • Proper signages should
• Proper be displayed
housekeeping at • Close supervision
work place should be done by the
• Safe working area supervisor and
platform safety officer
• Proper access and • A proper and certified
egress should be lifeline should be
provided for the installed for the
workers workers
DOCUMENT ELECTRONICALLY CONTROLLED - PRINTED COPIES VALID FOR FOURTEEN (14) WORKING DAYS
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Page 4 of 5
INTEGRATED HEALTH, SAFETY AND ENVIRONMENT STANDARD PROCEDURES Document No. ADM-FRM-005-1

Procedure Title
Effective Date 01 Jan 2018

HSE RISK MANAGEMENT

Revision / Date 3 / 10 Sep 2017

Risk Assessment Steps (to complete Risk Assessment Worksheet on Page 3)

Step 1: Identify Hazards Title (e.g. Physical Hazard, Fire Hazard, and Electrical Hazards).
Step 2: List Hazards Details identified (e.g. Tripping Hazard, Flammable Materials stored, Working in Electrical Cabinets).
Step 3: List Causes of Hazard (e.g. Untidy workplace, Hot work, un-isolated electrical supply).
Step 4: List Consequences of Hazard (e.g. Personnel Injury, Fire, electric shock).
Step 5: Determine Likelihood and Consequences to People, Assets, Environment, and Reputation from attached Risk Assessment Matrix (Page 2) (this should be the most probable outcome without controls and should be listed as 2A,
3D etc.).
Step 6. Calculate the Risk Index using the Qualitative or Semi-Quantitative Risk Assessment Matrix as deemed appropriate. This is a product of Likelihood and Consequence and should be stated Low, Medium, High or Very High).
Step 7. List Existing Controls. (e.g. Tidy Site Policy, Hot Work Permit, Isolation of Electrical Supply).
Step 8. List Safety Critical Activities and Additional Controls that may be deemed necessary to reduce risk level to ALARP.
Step 9: Recalculate Likelihood and Consequences to People, Assets, Environment, and Reputation from attached Risk Assessment Matrix.
Step 10. Recalculate the Risk Index.
Step 11. If residual risk deemed to be High or Very High then risk must be reduced further before proceeding, if risk is medium then note that risk reduction must be planned, monitored and documented, if risk is low then risk is
acceptable without required further action.
Notes

Risk Assessment Matrix – Qualitative LIKELIHOOD

Consequences People Assets Environment Reputation A B C D E

5- Catastrophic Multiple fatalities Extensive Massive effect International VERY

damage impact HIGH

4 - Severe Single fatality or Major damage Major effect National impact

ALARP
permanent HIGH
disability

3 – Critical Major injury or Localized Localized effect Considerable

MEDIUM
health effects effect impact

2 – Marginal Minor injury or Minor effect Minor effect Minor impact

health effects

1 - Negligible Slight injury or Slight effect Slight effect Slight impact LOW
health effects

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Page 5 of 5
INTEGRATED HEALTH, SAFETY AND ENVIRONMENT STANDARD PROCEDURES Document No. ADM-FRM-005-1

Procedure Title
Effective Date 01 Jan 2018

HSE RISK MANAGEMENT

Revision / Date 3 / 10 Sep 2017

Likelihoo
Descriptor to assist in Qualitative Assessment of Likelihood/ Frequency of Occurrence.
d

A Has occurred within port industry worldwide.

B Has occurred regionally within port industry or judged likely to have occurred.

C Has occurred in port industry within UAE or judged likely to have occurred.

D Has occurred in port industry within UAE on an annual basis or judged likely to have occurred.

E May occur in UAE port industry multiple times annually.

Risk Assessment Matrix – Semi-Quantitative LIKELIHOOD

Consequences People Environment Assets Reputation IMPROBABLE REMOTE OCCASIONAL PROBABLE FREQUENT
1 in 10,000 1 in 1000 1 in 100 1 in 10 Once in a
Years Years Years Years Year
A B C D E

5- Catastrophic Multiple fatalities Extensive Massive effect International VERY

or permanent damage impact
HIGH
total disabilities

ALARP
4 - Severe Single fatality or Major damage Major effect National impact HIGH
permanent
disability

3 – Critical Major injury or Localized Localized effect Considerable MEDIUM

health effects effect impact

2 – Marginal Minor injury or Minor effect Minor effect Minor impact

health effects

1 - Negligible Slight injury or Slight effect Slight effect Slight impact LOW
health effects

DOCUMENT ELECTRONICALLY CONTROLLED - PRINTED COPIES VALID FOR FOURTEEN (14) WORKING DAYS
©2017 ABU DHABI PORTS , ABU DHABI, UNITED ARAB EMIRATES